术后心房动和缺血性中风的长期风险
Gino Gialdini1, Katherine Nearing2, Prashant D Bhave3
1Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, New York.
JAMA
|August 14, 2014
概括
手术后新出现的外科手术期间心房动会增加缺血性中风的长期风险. 与心脏手术相比,在非心脏手术后,这种风险明显高于心脏手术.
科学领域:
- 心脏病学 心脏病学
- 神经学 神经学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 临床上明显的心房动是缺血性中风的已知危险因素.
- 与外科手术期间心房动相关的长期中风风险,通常被认为是对手术压力的短暂反应,仍然不清楚.
研究的目的:
- 调查新诊断的外科手术期间心房动与缺血性中风的长期风险之间的关联.
- 为了比较心脏手术和非心脏手术的患者之间的风险.
主要方法:
- 使用加利福尼亚州医院 (2007-2011) 的行政索赔数据进行了回顾性队列研究.
- 包括接受手术住院的患者,活着出院的患者,没有先前的脑血管疾病或心房动的患者.
- 使用验证的代码识别了新发的外科手术期间心房动,并跟踪了出院后的缺血性中风.
主要成果:
- 分析了超过170万名患者;1.43%的患者患有新发的外科手术前期心房动.
- 在出院1年后,中风发生率为0.99%与外科手术期间心房动相比,0.83%没有心脏手术后.
- 在出院1年后,中风发生率为1.47%与外科手术期间心房动,而非心脏手术后没有0.36%.
- 术后心房与心脏 (HR,1.3) 和非心脏手术 (HR,2.0) 后中风风险增加有关,非心脏手术后的关联更强.
结论:
- 新出现的外科手术期间心房动与缺血性中风的长期风险增加有关.
- 与心脏手术相比,在非心脏手术后,经外科手术期间心房动后中风的风险要高得多.
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